January 24, 2020
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Patients with Ebola virus, Lassa fever can be treated without infecting health care personnel

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Colleen Kraft, MD
Colleen S. Kraft

“Meticulous” implementation of infection control and clinical biosafety practices enable health care staff to treat patients infected with Ebola virus disease and Lassa fever without causing occupation-related symptomatic or asymptomatic infection, according to a study conducted in the Serious Communicable Diseases Unit at Emory University.

“We were very interested in an objective measure that showed that we were not exposed during our care of patients with Ebola and Lassa fever,” Colleen S. Kraft, MD, MSc, associate professor in the Department of Medicine, Division of Infectious Diseases and assistant professor in the Department of Pathology and Laboratory Medicine at Emory University School of Medicine, told Healio. “Emory University is a leader in immunology. A basic serology study could have an impact on our future care of patients, if we decided that we wanted to have baseline serologies on health care workers prior to caring for patients with high-risk infectious pathogens.”

Four patients with Ebola virus disease and one patient with Lassa fever were treated in the Serious Communicable Diseases Unit at Emory University Hospital between 2014 and 2016.

Stringent infection control and clinical biosafety practices were employed to stop nosocomial transmission of Ebola virus or Lassa fever to health care personnel. All personnel who entered the unit were required to measure their temperatures and fill out a symptoms questionnaire twice per day to test for exposure and asymptomatic seroconversion. Routine venipuncture was conducted on the day that informed consent was obtained, when Kraft and colleagues collected one serum tube from each participant.

In all, Ebola and Lassa fever antibody studies were completed on sera samples from 42 health care personnel. Of these, six health care workers who received an investigational chimpanzee adenovirus type 3 vectored Ebola glycoprotein vaccine had high antibody titers to Ebola glycoprotein, but none had responses to Ebola nucleoprotein or Lassa fever antigens.

According to Kraft, none of the health care workers participating in the study experienced an asymptomatic or symptomatic exposure to either disease based on serologic evidence.

“The take-home message locally is that we have high confidence in our use of personal protective equipment (PPE) and that our protocols with these PPE kept us safe,” Kraft concluded. “The generalizability has to do with the fact that other biocontainment units may want to establish baseline serology tests to make sure that we have a before-care comparator, if there is concern that the health care worker was exposed.” – by Caitlyn Stulpin

Disclosure: Kraft reports no relevant financial disclosures.